Anna Flaxis

I like acute care nursing, but I don't like the way the hospital is being run. I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can. These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.

When I worked in the hospital, I certainly found this to be true. While I was priveleged to care for many nice, respectful people, a significant proportion of patients and their family members arrived at the hospital with an adversarial attidude already in place. Sometimes, by using my charms, I could change the dynamic, but not always. I am more than willing to cut people slack for not being at their best because they are scared, in pain, or just not feeling well. But for some people, they just function at a baseline of entitlement and disrespect regardless of the circumstances, and I have no tolerance for that. Now that I work in an outpatient capacity, my experience is completely different. I have found most people are happy to see me, do not ask me to do things outside of my role, and are respectful of the knowledge and skills I possess. I am much happier as a nurse in this capacity. Sometimes when I consider going back to the hospital, this is definitely an issue that comes into play.

In the hospital I work in, ED positions are highly desirable, and transfers from another unit into the ED are handled as internal transfers. Internal transfers are based on seniority, if 2 different nurses are applying for the same ED slot, the one with more hospital seniority gets it. Could that be what is happening to you? If so, you just have to keep applying any time there is an opening. Eventually, you will be the one with seniority.

Weather, kids/grandkids/pets, hobbies, books/movies/TV shows, etc. I ask elderly people how long they've lived in the area, and that sometimes leads to stories about their lives. Sometimes poking fun at the way things work in the hospital can break the ice. It shows that you empathize with their frustrations about how long things can take to happen, or how many times they have to repeat their allergies, identity, what happened to bring them there, etc.

This is what your preceptor is for. Your facility should have written patient care guidelines somewhere as well. Ask your preceptor about that; maybe you could study those in your downtime.

I found this site; if you scroll down to "State Mandated Staffing Ratios", you will see that Ohio is not on the list. http://www.cnatips.com/ Here is a link to the Ohio Department of Health, the agency that regulates health care facilities. You could call and ask them. http://www.odh.ohio.gov/landing/phs_quality/quality.aspx From what I can gather with a simple Google search, it doesn't look like you have any legal protections, but that this is facility policy. If you have questions about how the work at your facility is distributed between shifts, best to ask your supervisor.

I'm more concerned about the residents' rights. To do 6 "get ups" by yourself, on third shift, this means you're starting at what, 3am?

True. A lot of these are actually cliches. Still, they are a fun read!

There was absolutely nothing hateful about my reply to you. I am sorry you interpreted it as such. Best of luck in your schooling.

I have certainly felt the way you do. I've even daydreamed about what else I would do, if not nursing. But, when it comes down to it, I'm not ready to give up on nursing yet. Whether you are ready is something only you can know the answer to. Best of luck to you in making your decision!

I don't think that by "finding information on your own", they mean posting on an internet bulletin board. Part of being a resourceful nurse is, when you don't know the answer to something, being able to find out using the right resources. Just asking someone else, who may or may not give you correct information, is not among those. You could try posting your question in the "students" section of this website. Perhaps someone there can point you to some resources that might assist you.

Well done!

Well, I wouldn't go *that* far.

I've had a couple of similar experiences. It really is refreshing, isn't it?

Thank you for that. I'm sure your experiences as a patient will help you to be the kind of nurse that you aspire to be. I think some of us, myself included, can be quick to be defensive, because we get treated like dirt every single day, usually by the least sick who have unrealistic expectations. It's really nice to hear a "thank you" every once in a while.